化疗前中性粒细胞与淋巴细胞比值对接受多西他赛化疗的去势难治性前列腺癌患者预后的影响  

Neutrophil-to-lymphocyte ratio as a prognostic factor in patients with castration-resistant prostate cancer treated with docetaxel-based chemotherapy

作　　者：张姣[1,2,3] 王海涛[1,2,3] 杨庆[4] 杜君[4] 贾炜莹[4] 张鹏宇[5] 

机构地区：[1]天津医科大学肿瘤医院介入治疗科,天津300060 [2]国家肿瘤临床医学研究中心,天津300060 [3]天津市肿瘤防治重点实验室,天津300060 [4]天津医科大学肿瘤医院泌尿肿瘤科,天津300060 [5]天津医科大学肿瘤医院检验科,天津300060

出　　处：《肿瘤》2015年第3期333-339,共7页Tumor

摘　　要：目的 :探讨化疗前中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)对接受多西他赛化疗的去势难治性前列腺癌(castration resistant prostate cancer,CRPC)患者预后的影响。方法 :回顾性分析2008年1月—2012年1月天津医科大学肿瘤医院收治的接受多西他赛方案化疗的48例CRPC患者的临床资料,分析NLR与临床资料和预后的关系。结果 :本组48例患者中,高NLR(>3)患者24例,低NLR(≤3)患者24例,2组患者的TNM分期和内脏转移率差异有统计学意义(P值均<0.05)。高NLR组与低NLR组的中位生存时间分别为11和25个月(P<0.05)。单因素分析结果显示,化疗前NLR、诊断时的TNM分期、Gleason评分、基线前列腺特异性抗原水平、美国东部肿瘤协作组体能状况评分、内脏转移、化疗周期数以及前列腺特异性抗原疗效是影响本组CRPC患者总生存的预后因素(P值均<0.05)。COX多因素分析结果显示,化疗前NLR、内脏转移、化疗周期数以及前列腺特异性抗原疗效是影响多西他赛化疗的CRPC患者总生存的独立预后因素(P值均<0.05)。结论:NLR是影响接受多西他赛化疗的CRPC患者总生存的独立危险因素,可作为对接受多西他赛化疗的CRPC患者的预后进行评估的有效指标。Objective： To investigate the prognostic value of neutrophil-to- lymphocyte ratio （NLR） in patients with castration-resistant prostate cancer （CRPC） treated with docetaxel-based chemotherapy. Methods： The medical records of 48 patients with CRPC were reviewed. These patients were diagnosed and underwent docetaxel-based chemotherapy in Tianjin Medical University Cancer Institute and Hospital between January 2008 and January 2012. Statistical analysis was performed to identify the clinical and prognosis value of NLR. Results： Of 48 patients with CRPC, 24 patients was in high NLR group （NLR 〉 3）, 24 in low NLR group （NLR ≤ 3）. TNM staging and visceral metastases were significantly different between two groups （both P 〈 0.05）. The median survival time of high NLR group and low NLR group were 11 and 25 months, respectively （P 〈 0.05）. Univariate analysis showed that NLR before chemothrapy, TNM stage, Gleason score at diagnosis, baseline prostate-specific antigen （PSA）, Eastern Cooperative Oncology Group performance status （ECOG PS） score, visceral metastases, number of chemotherapy cycles, and PSA efficacy were associated with poor overall survival of patients with CRPC （all P 〈 0.05）. COX multivariate analysis showed that NLR before chemothrapy, visceral metastases, number of chemotherapy cycles, and PSA efficacy were independent risk factors of overall survival of patients with CRPC （all P 〈 0.05）. Conclusion： NLR is an independent risk factor for prognosis of CRPC patients treated with docetaxel-based chemotherapy and can be used as an effective indicator to assess the prognosis of CRPC patients treated with docetaxel-based chemotherapy.

关 键 词：前列腺肿瘤 中性粒细胞/淋巴细胞比值 去势难治性前列腺癌 预后 多西他赛 

分 类 号：R737.25[医药卫生—肿瘤]